The relationship between hyperuricemia and contrast-induced nephropathy in patients with chronic kidney disease undergoing percutaneous coronary intervention
10.3760/cma.j.issn.0253-3758.2013.09.004
- VernacularTitle:高尿酸血症与慢性肾脏疾病患者经皮冠状动脉介入治疗后对比剂肾病的相关性
- Author:
Yuan-Hui LIU
1
;
Ning TAN
;
Yong LIU
;
Piao YE
;
Yi-Ting HE
;
Peng RAN
;
Lei JIANG
Author Information
1. 南方医科大学研究生学院
- Keywords:
Hyperuricemia;
Contrast media;
Nephrosis;
Angioplasty,transluminal,percutaneous coronary
- From:
Chinese Journal of Cardiology
2013;41(9):740-743
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between hyperuricemia and contrast-induced nephropathy (CIN) in patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI).Methods A total of 446 consecutive patients with CKD undergoing PCI in Guangdong general hospital were enrolled in this study.Patients were divided into hyperuricemic group (n =205) and normouricemic group (n =241).Hyperuricemia was defined as serum uric acid ＞ 420 μmol/L for male,＞357 μmol/L for female.CIN was defined as ≥44.2 μmol/L or ≥25％ increase from baseline Serum creatinine within 48-72 hours after contrast medium exposure,and that was not attributable to other causes.In hospital incidences of CIN and the major adverse cardiac events were compared between the two groups.The relationship between the incidence of CIN and hyperuricemia was evaluated by multivariate logistic regression analysis.Results CIN occurred in 16.6％ (74/446) of patients,and incidence of CIN was significantly higher in the hyperuricemic group than in the normouricemic group [23.9％ (49/446) vs.10.4％ (25/446),P =0.000].Patients who developed CIN had higher in hospital mortality [14.9％ (11/74) vs.1.3％ (5/372),P =0.000].Need for renal replacement therapy,acute heart failure,intraaortic balloon pump use and the hypotension after PCI were significantly higher in the hyperuricemic group compared with normouricemic group (P ＜ 0.01 or P ＜ 0.05).Multivariate analysis indicates that hyperuricemia (OR =1.9,95 ％ CI:1.1-3.5,P =0.037),age ＞ 75 years (OR =3.2,95 ％ CI:1.8-5.7,P =0.000),emergent PCI (OR =2.9,95 ％ CI:1.6-5.1,P =0.000) and anemia (OR =2.1,95 ％ CI:1.2-3.8,P =0.012) were predictors of CIN in patients with CKD.Conclusion Hyperuricemia is the independent risk predictor of CIN in patients with CKD undergoing PCI.
